Impact of Sacubitril/Valsartan in Cardiac Reverse Remodeling in Ischemic vs. Nonischemic Cardiomyopathy
Guideline directed medical therapy with beta blockers, ACEi/ARBs, and aldosterone antagonists with the goal of affecting cardiac reverse remodeling (CRR) has previously been the cornerstone of management of patients with heart failure with reduced ejection fraction (HFrEF). More recently, PARADIGM-HF demonstrated the superiority of sacubitril-valsartan to enalapril in reducing HF hospitalizations as well as cardiac and all-cause mortality. Other studies demonstrated that ARNI therapy may enhance CRR to a greater degree than ACEI or ARB therapy alone.
A 61-year-old African American man with history of hypertension, coronary artery disease, end-stage renal disease (on hemodialysis since 2014) and end-stage heart failure secondary to arrhythmogenic right ventricular cardiomyopathy (ARVC) underwent dual organ heart-kidney transplantation in May, 2019. Approximately two months after transplant mycophenolate was discontinued due to episodes of pancreatitis, leukopenia and detectable BK polyoma virus. Since then, the patient was maintained on tacrolimus (goal level 8 ng/mL) and low-dose prednisone (5mg/day).
Amyloid transthyretin (ATTR) cardiac amyloidosis (CA) is an increasingly recognized cause of restrictive cardiomyopathy and associated heart failure with preserved ejection fraction (HFpEF). Despite improved diagnostic techniques to identify this condition, many patients experience delayed diagnosis. Interpretation of routine cardiac biomarkers (i.e. troponins and brain natriuretic peptide (BNP)) and echocardiography in ATTR-CA is limited, particularly in relation to pyrophosphate (PYP) scintigraphy.
Patients with dilated cardiomyopathy (DCM) who achieved left ventricular reverse remodeling (LVRR) have a favorable prognosis, but it is still difficult to precisely predict LVRR in the clinical setting.
Postpartum cardiomyopathy (PPCM) is a prevalent cause of end-stage heart failure in women, from which about 10% will require heart transplantation. We aimed to further evaluate long-term heart transplant (HT) outcomes in this cohort of patients and compare them to all other heart transplant recipients.
Heart failure (HF) affects more than 6 million adults in the U.S and is associated with significant morbidity and mortality. The majority of HF patients suffer from either ischemic (ICM) or dilated (DCM) cardiomyopathy. Little is known about the genetic alterations in DCM or ICM patients. Therefore, our aim was to characterize differentially expressed genes in left ventricular tissue from DCM and ICM patients.
Myocarditis is a known etiology of both acute fulminant heart failure and chronic dilated cardiomyopathy requiring heart transplantation. We sought to evaluate the long-term post-transplant outcomes of pts with myocarditis.
We aim to evaluate clinical outcomes, echocardiographic changes, heart rate (HR) modifications and side effects in children with dilated cardiomyopathy (DCM) and chronic heart failure (HF) treated by high dosage of carvedilol.
Dilated cardiomyopathy (DCM) is a common cause of advanced heart failure (HF) in children and the risk of sudden death in DCM is not well defined although population-based studies have described risk factors like older age, familial DCM and lower fractional shortening. Myocardial fibrosis as assessed by late gadolinium enhancement (LGE) on 3-T cardiac magnetic resonance imaging (CMR) is well known to be associated with adverse events in DCM. We sought to assess the conditional survival (CS) of children and adolescents with DCM and advanced HF based on native T1 mapping (combined proton signal from myocytes and interstitium...
This study enrolled an institutional consecutive surgical series of 24 patients with refractory congestive heart failure under peripheral ECLS, related to fulminant myocarditis (n = 15), dilated cardiomyopathy (n = 5), or acute myocardial infarction (n = 4). They were converted to central Y-extracorporeal membrane oxygenation (ECMO,n = 6), extracorporeal ventricular assist device (EC-VAD,n = 12), or pump catheter (n = 6), dependent upon the degree of multiorgan failure. Despite the different degree of multiorgan failure prior to the convers...
This study demonstrates for the first time that senescent cells secrete functional LTs, significantly contributing to the LTs pool known to cause or exacerbate idiopathic pulmonary fibrosis. Against Senolytics https://www.fightaging.org/archives/2019/11/against-senolytics/ There is no consensus in science that is so strong as to have no heretics. So here we have an interview with a naysayer on the matter of senolytic treatments, who argues that the loss of senescent cells in aged tissues will cause more harm to long-term health than the damage they will do by remaining. To be clear, I think this to be a ...